| NPI | 1114943370 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: AZ LPC-22929) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: AZ LPC-2133) |
| Enumeration Date | 2006-07-14 |
| Last Update Date | 2024-04-11 |